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General NPI Number Information
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NPI Number | 1689547754
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Entity Type | Organization
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Legal Business Name | GENTLE HAVEN HOMES
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Dates
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Enumeration Date | 09/25/2025
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Last Update Date | 04/30/2026
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Provider Practice Location Address
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Address Line | 502 E WASHINGTON ST
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City | PULASKI
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State | TN
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Zip | 38478-3415
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Country | US
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Telephone | 256-750-2888
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Fax |
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Provider Business Mailing Address
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Address Line | 502 E WASHINGTON ST
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City | PULASKI
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State | TN
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Zip | 38478-3415
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Country | US
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Telephone | 256-750-2888
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Fax | 256-686-3740
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | LATASHA MCCLENDON
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Credential |
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Telephone | 256-750-2888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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